How much involvement is too much?

We've all heard our mom's tell us that just because one aspirin was good, two or three won't necessarily be better.  But what about our involvement as spouses, some involvement is good and expected, but can we be involved too much?  Especially in what could liberally be called, the affairs of state?  As evidenced here at SpouseBUZZ, there are innumerable examples and instances of the power of independent thought being followed by group action.  Some call that democracy at its best.

Okay -- back to the question. Is there ever, and what would be the mile marker to identify where we as spouses shouldn't tread when it comes to the operations of a military organization?  (Deep breath here.)

What if you heard that changes were coming to your local military medical treatment facility (MTF) that could directly impact you and your children's previous "norm" on expected care?

How many of you just had your knees jerk up and hit you in the chin?  C'mon, you can admit it to the old Toad-ster. 

Let's take this one step deeper.  Up to this point, your MTF had a separate pediatric section that was used solely for the care of dependent children.  But due to manpower shortages brought on by all of the now-common issues (deployments, shortage of doc's and medical tech's...), the decision was made to separate Active Duty Care away from a newly established "super clinic" which combines Family Practice and Pediatrics.  (read, Active Duty on one side, all others on the other side w/ lots of people/small area)

With the consolidation the medical care for the active duty member is now approaching its all-time best, in quality, timeliness, treatment and readiness.  But to accomplish the safe consolidation of family practice/ped's, there is a move afoot to reduce the number of "non-appointment children" in the MTF.  I.e, too many kids in too small an area, that are neither sick nor being entertained -- just kids being kids.  In other words, there's a proposed policy being circulated that at its essence says, Let's keep well kids away and keep them from being under-foot; if the kids don't have an appointment, could you please not bring them.

The uproar is huge.  And the spouses (via the established Spouse Club networks) are pinging the organizational commanders with frenzied and numerous "reasons" why the move is a detriment to them (not to the kids, but to them, the spouses). So frequent and harsh are the criticisms, that there is a possibility that all of the MTF consolidations might be reversed.  And as such, we'll return to longer wait times for all to get appointments, fewer health care providers spending too short a time w/ patients to keep the flow moving, but, at least there'll be a separate pediatric clinic w/ walls and doors.  However ...

... our active duty spouses will have a precipitous drop-off in their newly achieved readiness and care.

What do you think?  Have we spouses, by using the essence of democracy (independent thought/group action) by possibly bringing about a reversal of what could be clearly marked as being a military decision based upon military necessity, crossed the line?  If so, where was the mile marker that we missed?  What say you?  Is there a way to limit the children, and sustain better care?  Should we be able to bring all of our kids with us to our OB/GYN/Prostate check-ups? 

Let the beatings begin!  O&O, MaintenaneToadOne

Comments

[airforcewife]

Wouldn't it just be easier for the health care system the military uses to contract out cases that it is too full to care for? You know, sending sick children without available appointments to a local doctor as an immediate referral?

I know that this doesn't address the "how much is too much" question, but it does address the "why don't military planners think outside the box" issue. I'm truly sorry if the cost of treating dependants is more than what the budget called for, but that is a problem with cutting corners in the money allocation system and not too many deployments amongst medical personnel.

Our base actually has an after hours doc-in-a-box clinic on site for people who can't get to an immediate appointment. It's WONDERFUL.

[mismysailor]

I think as spouses we have to stand up for what we believe and the things that affect our families. This isn't a spouse going againist a Command for switching their spouse to nights this is a matter of medical care. As much as it sucks the Military is always going to do what's best for the Military members first and foremost and sometimes that leaves us out in the cold.

[MaintToad1]

AFW -- is your after-hours Doc-in-a-box a military person or civilian, w/ supporting cast (med techs) from where?

I personally believe and as a dad, would have loved to have carte blanche access to outside healthcare for the kiddos -- just need TRICARE to give us the word!

But we still need to address the question of someone bringing their "excess to the appointment" kids into the exam room next to where ol' Big Finger Sam (or Samantha) is checking me over.

And to the question of how much is too much involvement -- should we expect to have a say on policy?

M.M.Sailor -- "out in the cold" shouldn't ever happen. Ever. Check out the SpouseBUZZ links to TRICARE if you need a boost or an assist. As to policy on "how" that treatment should occur, I think a logical time to voice an opinion is a good thing -- we all could use some sage advice. But this hooplaa is all about the inconvenience to the spouse, not the care being provided to the patient. The spouses are aggitated over (A) the combining of Peds and Fam Practice and (B) the issue of not bringing "extra" children to the MTF as a matter of safety and "well kid in sick areas."

Are we crossing the line to actively and openly challenge a policy as a non-military spouse? Directly to Organizational Commanders? (... yes, yes, I know that "we" fight better knowing our wife and kids are being taken care of -- but that's not the situation here. We're all in garrison now.)

[Vypergirl]

The problem with not being able to bring well kids to an appointment is the fact that there is not always available childcare. Even with hourly care CDC, if there is no slot for your well child, then you can't change that and you have to pay for it. We have been through times i the past when we couldn't afford it even if I had wanted too. That is why I stay at home!

Let's say you just PCS'd, and you don't know anyone~much less anyone you would trust your kids with. Plus if you have just moved somewhere then your kids probably aren't even enrolled for hourly childcare yet.

When we were at Hood, the clinics there were combined and there was no time problems - at least there weren't for me. I can't speak for everyone.

I do have a problem with not allowing a parent to bring their "extra" children. Just one more thing that a parent of a sick child has to worry about - on top of the sick child!

[airforcewife]

The after hours doc that I saw was a contracted retiree. And he was simply amazing - not only did he check my deer tick bites and prescribe me the Lyme Disease meds in nothing flat, he also cracked my back as an added bonus when I mentioned that I had been putting off going to the chiropracter. GREAT guy. But the fact that I was told to wait for the after hours clinic when I noticed deer tick bites and was getting headaches is sheer lunacy in itself. And, unfortunately, not uncommon.

I've had to bring excess kids to appointments, and I hate it. I've had to bring my roiling horde of kids to MY appointments, something I hate even more. But there's really nothing I can do about that when hubby is gone and I can't find someone to babysit. It's either take the excess kids, or not get treatment. And I think a lot of people have the same issues.

Perhaps if people were actually seen when their appointments were scheduled, rather than two hours later, the overcrowding of excess children wouldn't be such an issue.

Not to be overly harsh - but a lot of the argument seems to be over addressing the symptoms rather than treating the problem(s).

[Jewel]

Yes, I think in this instance spouses have crossed the line. Ok, ok...before you all hit me with your best shot for my last remark let me tell you that I've been around the Air Force for quite a long time and I've noticed a change in attitude amongst the younger (and not so younger) set. From so many of them I get the feeling they think the Air Force "owes" them EVERYTHING! From what I gather from this post, the MTF is not taking away their medical care, only asking they not bring their well kids to the clinic. I say BIG DEAL and GROW UP!! What ever happened to a babysitting co-op or neighbor-helping-neighbor? I mean come on people! It only makes sense that the MTF wouldn't want well kids in cramped quarters with other sick kids/adults because in a week or two that so called well kid will be right back in the clinic for treatment of the bug he caught when he was there with his mom and sick sister. I know some of you may think my words a little harsh, but lets get real here. Save your energy for the time when you are truly faced with something unjust.

[Jen]

In this day and age of almost constant deployments, and homes being run by one parent, the LAST thing an MTF needs to do is further burden those parents with asinine policies like no extra children. The places we've been that have had that policy....well, let's just say the policy was not followed by this Army wife. I did what I needed to do - obtain medical care for my child, while providing supervision for the others. It's not something that is fun for me - I'd rather not take the kids into the germ fest called Peds at all - but it's what was necessary to the care of the family.

Civilian peds and family practice docs don't have this policy. Why should an MTF be able to? It's an extra burden on an already stressed parent to find child care for siblings when you need to take a sick child in.

[Tamber]

Let me preface this statement with the fact that I do not have children. Thus, take my comments as seen through that lens. I am stationed in Germany, in a high OPTEMPO community. We have a serious shortage of medical personnel. Most of the Soldiers are deployed, leaving a lot of single moms. Due to language and cultural differences, most spouses want to be seen on-post. This is nearly impossible. It is very difficult for a family member to get an appointment, ever. "Extra" or well children are not permitted in the clinic. Until recently it was very difficult to get last-minute hourly childcare for medical appointments through CYS. Thanks to a big uproar from the community along with a fabulous new clinic Commander, programs are being put into place guaranteeing childcare during medical appointments, often at reduced or no cost to families. When you call to make a same-day or routine appointment, you are asked, "Do you require childcare?" (Since I do not, I am not sure of the process from that point, but the feedback for the program has been very positive). I feel that the number one priority at the clinic should always be the service member. And if that means inconveniencing the families a little bit, so be it. Yes, we are inconvenienced a lot in the military, but that just means that we know how to deal with the hassle. If the proposed changes are going to benefit the active duty population, I feel that the public outcry might be better used in addressing the childcare issues, rather than the restructuring at your clinic. Instead of trying to go back to the "old" way, which might compromise care, why not put that energy into finding ways to improve the "new" situation-- like the availability of low-cost (or free), convenient childcare to be used only for medical appointments.

[Annie]

On one hand, it does sound to me like spouses may have crossed the line. Finding that line is always hard, I think, especially once group inertia takes over. I can't help but think, though, that the "powers that be" certainly have other options in response to the criticism than to completely reverse the consolidations that they originally found to be the most workable solution to readiness/budget challenges. Surely the reversal of their plan doesn't have to be the answer (not that I'd claim to know what the answer should be!).

Where we are, there is a "separate pediatric clinic w/ walls and doors", and that clinic (along with all others I've visited on base) has now posted a "rule" about not bringing in the excess kids. Most clinics don't seem to enforce the rule, but it's posted. I've always worried about it because it just can't be assumed that one can always get childcare. There are frequently cost concerns, particularly for single-income families, not to mention the nature of our community is that many are very new in town, and many are living as single parents temporarily. IMO, at LEAST the pediatric clinic (or whichever clinic sees children) needs to allow the "extra" children in. Childcare often requires notice and planning, especially for those of us living far from family and friends. And as all parents know, you can't always plan when you will need to have a sick child seen.

I can see, though, where clinics would need to do something about situations where "excess" children are causing a disturbance to patients/families. The "rule" probably is all they can think of to deal with that.

[Annie]

Read Tamber's comments after posting my own, and I must say, Amen!

[Audette]

Like another who posted a comment, I do not have any children, and would like to mention that as a potential bias first.

It sounds as if the main issue at hand is accessible short-term childcare. I would be willing to bet that just about any parent with a sick child would love to have an available option (within their means) that would have their extra children in some form of care during a doctor's visit. I suspect that the extra children are there more because there is not another option, as opposed to them being there because the parent feels the urge to bring along the entire family for one child's doctor's visit.

So, I'll admit that I find a policy against extra kids a bit high-handed, and I would be fairly frustrated about it. Unless that policy was put in place along with increasing the availability of short-term accessible childcare.

[MO]

I think we should get the same respect and set up as civilians, end of story! Not being treated like cattle, please keep your motrin, and when my child is sick I don't want to wait five hours in an ER because there is no doctor available or because I can't get my child to an appointment until five days to two weeks later. By then we may not be sick any more .......... You know what don't get me started on the military's answer to healthcare, it has always my biggest gripe over the years. I wont bore you all with it.

[MrsD]

Being a Guard wife, perhaps I don't understand. Isn't your healthcare free? I mean, you don't pay premiums every pay period and you don't pay anything out of pocket for doctor visits, diagnostic tests, treatments or medications, right? Your MTF is usually just minutes away, right?

We pay $270 per month in premiums. We pay $10 per visit "in area" and who knows how much "out of area". When I was hospitalized for 5 days a couple of years ago, we ended up paying, out-of-pocket, over $1000 per day, total. We just moved, so I am looking for a new doctor. We are having to be "approved" to be patients of the only clinic that takes our insurance and that clinic is an hour's drive from our home. And, yes, even out here in the real world, I will have to wait who knows how long when I go for an appointment.

In the end, paying for childcare has to be cheaper than private sector health care. Just my humble opinion.

[Kel]

I have never taken my children to "female" appts. That is a no go zone unless they are infants and just do not know what is going on.. I ask neighbors to do a co-ap childcare for appts and that so far has worked out.

One thign that has a lot of people in an upraor at htis base is the establishment of a well clinic. You r children do not see their PCM if it is a routine checkup (unless they are special needs or were preemies) In this clinic you must take a "class" 15 minutes prior to your appt. So now not only do you have an appt at say 2:45 that you are supposed to be there 30 minutes prior to instead of the normal 15 minutes just to sit after the "class" until 4pm when you are finally called back. I personally think it is to much to ask of parents to pay for 3-4 hours of childcare for one appt. or to sit there that long with a toddler.. THey need to do something to better the medical system on bases. IMO

[MaintToad1]

Good Evening Mrs D.-- as I read through the various responses, yours and a few others show not only the range of ideas on medical care, but help us all to understand, "we" don't have anything close to a medical plan that fits all of us. Thanks for taking a moment to highlight that our Guardsmen and Reservists are dancing to a completely different tune then those of us married to active duty.
But I do need to clarify something. As to the “free” health care you address … don’t believe that’s written anywhere in my wife's contract. Rather I believe the premise is, that healthcare will be provided at no cost to the active duty military member only. No where does it state, “… and to their family and to retirees.” It's my understanding of today’s military healthcare for dependents and retirees, that it isn’t “free” rather “cost effective.” There’s a difference. When I go "on the economy" for health care, I pay any over & above costs not covered by TRICARE, just like your plan makes you do. When using outside care, I have to meet a series of annual catastrophic "caps" in the thousands of dollars before I don't have to pay anything, which is very similar to you. Now, what we as family members of active duty don't have to pay, are any monthly premiums. But as a retiree, I do have a pretty large monthly premium if I wish to sustain TRICARE Prime. But if as a family member or retiree (after buying-in to PRIME coverage) I'm treated in a MTF, there is no (extra) charge. So, technically free it's not. Like you, there are rules out the yingyang. We do though, have it pretty good I believe for all the reasons you so ably point out. AND I for one, am quite thankful. (but that's another post)
But the issue on the table remains, what's your thoughts on -- should we as spouses be able to use email and the internet to impact organizational commanders on military policy decisions at the garrison level? And, if yes, which ones and where's the mile marker so we'll know when to stop? ... Mrs D, Thanks for talking with us this evening! Toad

[phyllis]

One more reason to keep my own personel insurance and not use the militarys. My dh is ANG so I have always covered insurance for the family. It is free and considered part of my benifit package which is why I work were I do. As for the kid thing sometimes you have no choice and you bring them with a bag of toys. As to nagging the comander, how do they know what its like unless we tell them. They don't have to listen.

[Love My Tanker]

I delay my female appointments each year until I know that I have childcare. Otherwise, I often times have no choice other than to take myself and my children to my other appointments or the appts of my other children.

As Vypergirl stated, finding childcare can be very difficult and is an issue for many parents. This is why many parents end up neglecting their own healthcare. Parents with non school aged children are always going to run into these issues, especially when a service-member is deployed, they are newly relocated or simply when childcare is not available. I also have the issue that I homeschool my children and where I go, they must go. Other than my trying to find a babysitter, childcare during school hours is not available for my kids, even if I must go to the doctor.

I suppose if we end up dealing with MTF issues and I am told I cannot bring children or my other children, we will just have to switch to Tricare Standard, suck up the costs and brave the civilian medical world.

Interesting post Toad and very interesting comments all!

[liberal army wife]

I remember this problem waaaay back in the olden days, when we were overseas. and there weren't deployments to figure in. neighbours to babysit, the best and in our case ONLY solution. but when I just moved there... that was really scary.

As for whether we should let the CO know how things like this are affecting the families, SURE we should. How else will Command know?? Is there an ombudsman for the family concerns, will the ombudsman listen or will command listen to that person???

LAW

[phyllis]

I just remembered in the BIG mall were we live across the street their is babysitting by the hour. Maybe their is more of those places in your areas.

[Demonia]

Ft Hood started to send dependents of active duty off post to civilian doctors in the middle of 2007. This has served to be a very, very good thing. I can get appointments right when I need them and usualy try to get all of my kids (4) appointments on the same day. There are times when I have had to bring my children to my apointments but usualy only when it is an emergency. If I make a routine appointment for myself I will make it a month or more ahead of time so that I can find daycare and if not cancel the appointment. Tricare does give us the option to go to any doctors, at leste here in this area as long as the doctor accepts tricare. We pay for persciptions filled at non military pharmices. We also, as family members, pay for anything extra and whatever is left on the cost for the tratment after tricare covers it.
If you are waiting for too long to see your doctor or ped for sick kids then contact your tricare office and see if you can go have your PCM changed over to someone else who can give you and your children the care they need. There is always the option to change something if it needs to be changed. There needs to be at least one seperate clinic soley dedicated to PEDS so that there is not so much of an issue of children getting underfoot of other docs/patients. Children are less likly to be unruly in a child friendly enviornment so then it would just be up to the parents to get there children to behave.